University of North Carolina, Chapel Hill scientists, reporting in the
online journal Vaccine, say anecdotal accounts and news stories have
stressed the side effects of the HPV vaccine, including reports of painful
injections.

The researchers say health care professionals are concerned that these
reports may keep young women and others from getting the vaccine or completing
the three-dose series, which is recommended.

The HPV vaccine administered during the study period was Gardasil, which
protects young women from strains of the virus that cause a majority of
cervical cancers and genital warts. Only about 37% of adolescent girls in the
U.S. who are eligible for the shots have initiated the three-dose series.

The researchers conducted surveys in 2008 with parents of girls aged 11-20
living in areas of North Carolina with elevated cervical cancer rates who had
received at least one shot of HPV vaccine.

Parents reported that pain at the time of HPV vaccination was less frequent
and less severe than tetanus or meningococcal vaccines. Compared to all other
vaccines received by their daughters, 69% of parents reported that HPV vaccine
caused their daughters the same amount of pain or discomfort at the time of the
shot. Seventeen percent reported that they experienced less pain from the HPV
vaccine, and 12% reported it caused more pain.

"These findings may be important to increase HPV vaccination coverage,"
write the researchers, who include Paul L. Reiter, PhD, of the University of
North Carolina's Gillings School of Public Health.

"Some stories about HPV vaccine side effects and pain have been downright
scary," Reiter says in a news release. "However, most parents in our study
reported their daughters experienced the same amount of pain or even less pain
from the HPV vaccine compared to these other vaccines."

The team reports it found that parents who reported that daughters who
completed the series of shots reported pain from the shots just as often as
those who were late for subsequent doses.

The findings could increase the number of young women who start and finish
the vaccine series by dispelling the myth that the shots are painful, says Noel
T. Brewer, PhD, senior investigator of the study.

"It's important for parents and health care providers to be aware of these
findings," Brewer says in the news release. "Doctors and parents can now make
better informed decisions about giving adolescent girls HPV vaccine."

The main message of the study: "Getting the HPV vaccine hurts less than you
think," Brewer says.

HPV Vaccine vs. Other Vaccines

The study was done by telephone interview of 229 parents in five North
Carolina counties.

The study found that:

65% of parents reported their daughters suffered some pain or discomfort
after receiving an HPV vaccine, with more reported at time of injection than in
the hours and days that followed.

Few parents said their children experienced moderate or severe pain at the
time of injection or afterward.

Parents were more likely to report their daughters suffered a higher level
of pain or discomfort from tetanus booster shots and meningococcal
vaccines.

More parents reported pain at the time of tetanus shot or meningococcal
vaccine than the HPV vaccine.

"While many parents in our study reported their daughters experienced pain
or discomfort after receiving HPV vaccine, the reported pain was less frequent
and less severe than that associated with other adolescent vaccines and did not
affect completion of the HPV vaccine regimen," the researchers write.

The researchers urge health care providers to inform parents and their
daughters that pain from the HPV shots has been reported as being similar to or
less than the discomfort from other adolescent vaccines.

One researcher, Jennifer Smith of the UNC Lineberger Comprehensive Cancer
Center, reported receiving research grants or contracts, honoraria, or
consulting fees in the last four years from GlaxoSmithKline and Merck.
GlaxoSmithKline makes Cervarix, a vaccine recently approved to prevent cervical
cancer in girls and young women. Merck manufacturers Gardasil, recently
approved to prevent genital warts in boys and men.

Brewer acknowledges receiving a research grant from Merck on men's attitudes
toward HPV, but received no honoraria or consulting fees from Merck or
GlaxoSmithKline.